A Scoping Review of Biobehavioural Interventions to Improve PrEP Continuum of Care in Latin America

According to the literature, biobehavioural interventions or combined strategies would reduce the risk of HIV infection by more than 7,000 new cases each day, which would contribute to the battle facing Latin America, where despite the high incidence and prevalence of HIV in the region, access to PrEP (pre-exposure prophylaxis) is very limited. The objective of this research was, consistent with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to conduct a scoping review to assess the evidence of available outcome data on biobehavioural interventions and programs to address gaps in the PrEP continuum of care in Latin America. The search was conducted in the databases EBSCOhost, WoS, Scopus, and ProQuest, and include all studies published from 2010 to 2021. One hundred eighty-six studies were identified and evaluated according to the eligibility criteria in six stages starting with the elimination of duplicates until the selection of studies that met the previously mentioned criteria; at the end five studies were chosen which were submitted to the methodological quality assessment including compliance with ethical guidelines. Results show that biobehavioural interventions promoting PrEP in Latin America are effective in increasing condom use, decreasing HIV risk, and increasing PrEP awareness, uptake, adherence, and retention. The limited number of interventions in the PrEP continuum of care indicates a need for the uptake of dissemination and implementation science (D&I) frameworks. D&I could help facilitate the translation of evidence-based practices, interventions, and policies to address the HIV crisis in Latin America.

Según la literatura, las intervenciones bioconductuales o estrategias combinadas reducirían el riesgo de infección por VIH en más de 7000 nuevos casos cada día, lo que contribuiría a la batalla que enfrenta América Latina, región en la que, a pesar de la alta incidencia y prevalencia del VIH, el acceso a la PrEP (profilaxis preexposición) es muy limitado. De acuerdo con las directrices de PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), el objetivo de esta investigación fue realizar una revisión de alcance para evaluar la evidencia de los datos de resultados disponibles sobre intervenciones bioconductuales y programas para abordar las brechas en el continuo de atención de PrEP en América Latina. La búsqueda se realizó en las bases de datos EBSCOhost, WoS, Scopus y ProQuest, e incluyó todos los estudios publicados de 2010 a 2021. Se identificaron ciento ochenta y seis estudios, y se evaluaron de acuerdo con los criterios de elegibilidad en seis etapas, iniciando por la eliminación de duplicados hasta la selección de estudios que cumplieran los criterios previamente mencionados; al final se eligieron cinco estudios, los cuales fueron sometidos a la evaluación de calidad metodológica, incluyendo el cumplimiento de los lineamientos éticos. Los resultados muestran que las intervenciones bioconductuales que promueven la PrEP en América Latina son efectivas para aumentar el uso del condón, disminuir el riesgo de VIH y aumentar la conciencia, la aceptación, la adherencia y la retención de la PrEP. El número limitado de intervenciones en el continuo de atención de la PrEP indica la necesidad de adoptar marcos científicos de difusión e implementación (D&I); marcos que podrían ayudar a facilitar la traducción de prácticas, intervenciones y políticas basadas en la evidencia para abordar la crisis del VIH en América Latina.

A Scoping Review of Biobehavioural Interventions to Improve PrEP Continuum of Care in Latin America.

According to the literature, biobehavioural interventions or combined strategies would reduce the risk of HIV infection by more than 7,000 new cases each day, which would contribute to the battle facing Latin America, where despite the high incidence and prevalence of HIV in the region, access to PrEP (pre-exposure prophylaxis) is very limited. The objective of this research was, consistent with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to conduct a scoping review to assess the evidence of available outcome data on biobehavioural interventions and programs to address gaps in the PrEP continuum of care in Latin America. The search was conducted in the databases EBSCOhost, WoS, Scopus, and ProQuest, and include all studies published from 2010 to 2021. One hundred eighty-six studies were identified and evaluated according to the eligibility criteria in six stages starting with the elimination of duplicates until the selection of studies that met the previously mentioned criteria; at the end five studies were chosen which were submitted to the methodological quality assessment including compliance with ethical guidelines. Results show that biobehavioural interventions promoting PrEP in Latin America are effective in increasing condom use, decreasing HIV risk, and increasing PrEP awareness, uptake, adherence, and retention. The limited number of interventions in the PrEP continuum of care indicates a need for the uptake of dissemination and implementation science (D&I) frameworks. D&I could help facilitate the translation of evidence-based practices, interventions, and policies to address the HIV crisis in Latin America.

Según la literatura, las intervenciones bioconductuales o estrategias combinadas reducirían el riesgo de infección por VIH en más de 7000 nuevos casos cada día, lo que contribuiría a la batalla que enfrenta América Latina, región en la que, a pesar de la alta incidencia y prevalencia del VIH, el acceso a la PrEP (profilaxis preexposición) es muy limitado. De acuerdo con las directrices de PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), el objetivo de esta investigación fue realizar una revisión de alcance para evaluar la evidencia de los datos de resultados disponibles sobre intervenciones bioconductuales y programas para abordar las brechas en el continuo de atención de PrEP en América Latina. La búsqueda se realizó en las bases de datos EBSCOhost, WoS, Scopus y ProQuest, e incluyó todos los estudios publicados de 2010 a 2021. Se identificaron ciento ochenta y seis estudios, y se evaluaron de acuerdo con los criterios de elegibilidad en seis etapas, iniciando por la eliminación de duplicados hasta la selección de estudios que cumplieran los criterios previamente mencionados; al final se eligieron cinco estudios, los cuales fueron sometidos a la evaluación de calidad metodológica, incluyendo el cumplimiento de los lineamientos éticos. Los resultados muestran que las intervenciones bioconductuales que promueven la PrEP en América Latina son efectivas para aumentar el uso del condón, disminuir el riesgo de VIH y aumentar la conciencia, la aceptación, la adherencia y la retención de la PrEP. El número limitado de intervenciones en el continuo de atención de la PrEP indica la necesidad de adoptar marcos científicos de difusión e implementación (D&I); marcos que podrían ayudar a facilitar la traducción de prácticas, intervenciones y políticas basadas en la evidencia para abordar la crisis del VIH en América Latina.

Colombian adolescents fail in knowledge regarding HIV and other sexually transmitted infections / Adolescentes colombianos fracasan en conocimientos sobre VIH y otras infecciones de transmisión sexual

Abstract Introduction/objective: Sexually transmitted infections (STIs) -HIV included- are a major problem in Latin America, mainly in Colombia. In 2021, 17647 cases were reported, which compared to the previous year showed an increase of 29.7%. The main aim of this study was to assess the knowledge regarding HIV and other STIs among the adolescent population in Colombia. Method: A total of 2012 Colombian adolescents between 12-19 years of age participated in this study. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI), a self-report measure, was administered. Results: The results showed moderate to low general knowledge (M = 9.90, SD = 4.64) regarding HIV and other STIs. Adolescents did not know if a tongue-kiss led to an HIV infection (75%), or whether both the vaginal ring and the IUD were effective methods for preventing HIV/AIDS (82%). Results showed better scores in knowledge regarding HIV transmission (84%), HIV testing (66%), and condom use to prevent HIV infection (71%). Conclusions: Significant differences were observed in HIV/STIs knowledge between both sexes, but the effect magnitudes were small. Thus, these differences were neglected. This study contributes to understanding the state of knowledge and strengthening prevention strategies of professionals linked to the field of quality of life, education, and sexual healthcare in Colombia.

Resumen Introducción/objetivo: Las infecciones de transmisión sexual (ITS) y el VIH son un gran desafío en América Latina, principalmente en Colombia. Para el 2021 se reportaron 17 647 casos, que comparados con el 2019 muestran un incremento del 29.7 %. El objetivo principal de este artículo fue evaluar el conocimiento sobre el VIH y otras ITS en la población adolescente de Colombia. Método: En este estudio participaron un total de 2012 adolescentes colombianos con edades entre los 12 y los 19 años. Se administró la Escala de Conocimientos sobre el VIH y otras infecciones de transmisión sexual (KSI) y una medida de autoinforme. Resultados: Los resultados mostraron un conocimiento general de moderado a bajo (M = 9.90, SD = 4.64) sobre el VIH y otras ITS. Las adolescentes no sabían si un beso con lengua conducía a una infección por el VIH (75 %) o si tanto el anillo vaginal como el DIU eran métodos efectivos para prevenir el VIH/SIDA (82 %). Los resultados mostraron mejores puntuaciones en conocimientos sobre la transmisión del VIH (84 %), pruebas de detección del VIH (66 %) y uso de preservativos para prevenir la infección por el VIH (71 %). Conclusiones: Se observaron diferencias significativas en el conocimiento del VIH/ ITS entre ambos sexos, pero los tamaños del efecto fueron pequeños. Por tanto, estas diferencias fueron despreciadas. Este estudio contribuye a comprender el estado del conocimiento y a fortalecer las estrategias de prevención que realizan los profesionales vinculados al campo de la calidad de vida, la educación y la salud sexual en Colombia.

The Impact of COVID-19 and Immigration Enforcement on Service Delivery for Immigrant Origin Families Involved in the Child Welfare System.

This descriptive study sought to explore how child welfare agencies and community partner organizations experienced and adapted service provision for immigrant children and families during the COVID-19 pandemic. Semi-structured qualitative interviews were completed with 31 child welfare agency practitioners and community partners in 11 states who work with immigrant clients or on immigration related policies within the child welfare sector. Data were coded and analyzed using a thematic analysis approach. Results: Findings documented ongoing immigration-related fears in accessing services due to the anti-immigrant climate as well as increased scarcity of resources and basic needs stressors among immigrants served by the child welfare community during the pandemic. Results also identified child welfare systemic and structural barriers to accessing needed case supports for immigrants, in addition to innovative practice and policy adaptations to meet immigrant needs during the pandemic. COVID-19 created overwhelming challenges for already overburdened immigrant families at risk of or involved with the child welfare system. Child welfare agencies should foster collaborations with immigrant-serving community organizations who can share information and resources about COVID-19, immigration enforcement, and vaccine distribution. Agencies should adopt policies for tele-visiting that support transnational participation in virtual family visits and court hearings to create more equitable opportunities for reunification and permanency.

Systematization of oral hygiene in a pediatric patient: case report / Sistematización de la higiene oral en un paciente pediátrico: reporte de caso

Oral hygiene is an important step in the control of the biofilm, a factor related to diseases such as gingivitis and tooth decay. The systematization of oral hygiene in children is a set of measures that seeks to achieve sequential learning, thus guaranteeing a better elimination of the biofilm. Objetive: To show a sequence of systematized steps in oral hygiene in a pediatric patient with a definitely positive behavior. Case Report: Six year old female patient, without relevant medical history. On clinical intraoral examination presented biofilm accumulation and swollen gums. The presumptive diagnosis was marginal gingivitis associated with biofilm, the treatment included a preventive phase with motivation and education. The control of the disease evolution was carried out with a card of Systematization Technique of Oral Hygiene, the methodology included the recording of the educational sessions using videos and photographs. Results: the adequate use of the amount of toothpaste was achieved, the integrity was improved to 100%, the brushing time increased from 24 to 120 seconds and it was possible to add tongue brushing and not rinsing after brushing within the oral hygiene routine. Conclusion: The patient was able to clean all dental surfaces, using homogeneous times for each surface, following an orderly sequence in toothbrushing, as well as to acquire knowledge regarding the amount of toothpaste to use, tongue brushing and not rinsing after toothbrushing. The systematization of oral hygiene allowed us to achieve these achievements in six sessions.

La higiene oral es un paso importante para el control de la biopelícula, la cual es un factor relacionado con enfermedades como gingivitis y caries dental. La sistematización de la higiene oral en niños es un conjunto de medidas que buscan lograr un aprendizaje secuencial, garantizando así una mejor eliminación del biofilm. Objetivo: Mostrar una secuencia de pasos sistematizados en la higiene oral en un paciente pediátrico con comportamiento definitivamente positivo. Reporte de un Caso: Paciente femenino de 6 años, sin antecedentes médicos relevantes. Al examen clínico intraoral presentó acumulación de biofilm y encías inflamadas. El diagnóstico presuntivo fue gingivitis marginal asociada a biofilm, el tratamiento incluyó una fase preventiva con motivación y educación. El control de la evolución se realizó con una ficha sobre la Técnica de Sistematización de Higiene oral, la metodología incluye el registro de las sesiones educativas usando vídeos y fotografías. Resultados: se logró el uso adecuado de la cantidad de dentífrico, se mejoró la integridad al 100%, el tiempo de cepillado pasó de 24 a 120 segundos y se consiguió integrar el cepillado de la lengua y el no enjuague post cepillado dentro de su higiene oral. Conclusión: La paciente consiguió realizar la limpieza de todas las superficies dentales, tiempos homogéneos para cada superficie, una secuencia ordenada en su cepillado dental, así como adquirir conocimientos en la cantidad de dentífrico utilizado, el cepillado de la lengua y el no enjuagarse después del cepillado dental. La sistematización de la higiene oral permitió conseguir estos logros en 6 sesiones.

Psychometric Properties of the Condom Use Self-Efficacy Scale among Young Colombians.

(1) Background: This study evaluated the psychometric properties of the Condom Use Self-Efficacy Scale among Colombian youth. (2) Method: A total of 2873 men and women between 18 and 26 years old (M = 21.45, SD = 2.26) took part in this study. All participants answered a socio-demographic survey, the Condom Use Self-Efficacy Scale, the UCLA Multidimensional Condom Attitudes Scale, The Condom Use Errors and Problems Scale, and the Sexual Assertiveness Scale. Sampling was web-based, and the survey was distributed via Facebook. (3) Results: The Condom Use Self-Efficacy Scale demonstrated adequate reliability (ordinal α ranged = 0.76 to 0.92). Exploratory and confirmatory factor analysis suggested a four-factor structure with an explained variance of 69%. This dimensionality was also invariant across gender. Moreover, positive attitudes toward condom use were significantly associated with appropriation and assertiveness. Two dimensions (appropriation and partner disapproval) showed significant gender differences. (4) Conclusions: The Spanish-Colombian version of the Condom Use Self-Efficacy Scale is a psychometrically adequate instrument to measure perceived condom use self-efficacy. This scale can be used in both research and professional settings to measure self-efficacy at using condoms in young people.

Capacidad de formación de biopelículas en especies del género Candida de procedencia clínica / Capability of biofilm formation in Candida genus species of clinical origin

El objetivo de la investigación fue evaluar la capacidad de formación de biopelículas en especies del género Candida provenientes de muestras clínicas con procesos infecciosos. La muestra estuvo constituida por 70 aislados obtenidos de laboratorios clínicos privados. Para la identificación de las especies se utilizó la Prueba de tubo germinativo y la técnica de microcultivo en agar harina de maíz con tween 80, mientras que la cuantificación de la capacidad de formación de biopelículas se realizó por la técnica de microplaca de poliestireno. Entre los resultados obtenidos en la investigación las especies aisladas fueron: Candida glabrata (34%), Complejo Candida albicans (30%), Complejo Candida parapsilosis (27%) y Candida tropicalis (9%), de las cuales 41 aislados (59%) formaron biopelículas, resultando el Complejo Candida albicans y Candida glabrata las especies con mayor grado de formación de biopelículas con 29% cada una, seguida de Complejo Candida parapsilosis con 27% y Candida tropicalis con 15%. Las cepas que tuvieron mayor formación de biopelículas provenían de orina, seguidas de secreción ótica, secreción vaginal y sangre, sin embargo al aplicar la prueba de Chi-cuadrado (x2) de Pearson se determinó que no existe asociación estadísticamente significativa entre la capacidad de formación de biopelículas y el grado de formación con la procedencia clínica así como tampoco hay asociación entre la capacidad de formación de biopelículas y grado de formación con la especie involucrada (p > 0,05)

The aim of this research was to evaluate the capability of biofilm formation in Candida genus species from clinical samples with infectious conditions. The sample consisted of 70 isolates obtained from private clinical laboratories. Germ tube test and agar cornmeal with tween 80 microculture technique were used as species identification, meanwhile, quantification of biofilm formation capacity was performed by the polystyrene microplate technique. Among the results obtained in the research, isolated species were: Candida glabrata (34%), Candida albicans Complex (30%), Candidaparapsilosis Complex (27%) and Candida tropicalis (9%), of which 41 isolates (59%) formed biofilms, resulting Candida albicans and Candida glabrata Complex species with the highest degree of biofilms with 29% each, followed by Candida parapsilosis Complex with 27% and Candida tropicalis with 15%. Strains with more biofilm formation came from urine, followed by ear discharge, vaginal secretion and blood. However, by applying the Chi squaretest the Pearson, it was determined that there was no statistically significant association between thecapability of biofilm formation and the formation degree with clinical origin, neither there is association between the ability of biofilm formation and the formation degree with the species involved (p> 0.05).

Conocimiento de médicos de 2 hospitales peruanos sobre la relación entre enfermedad periodontal y alteraciones sistémicas / Knowledge of physicians, from 2 peruvian hospitals on the relationship between periodontal and systemic diseases

Objetivo: Determinar el nivel de conocimiento sobre la enfermedad periodontal y su relación con la diabetes mellitus, la gestación y las enfermedades cardiovasculares, en médicos de 2 hospitales peruanos. Material y método El presente estudio, transversal y descriptivo, se desarrolló entre abril y mayo de 2014 e incluyó un total de 77 médicos, 39 del Hospital Belén de Trujillo y 38 del Víctor Lazarte Echegaray (Trujillo, Perú), a quienes se les aplicó un cuestionario, sometido previamente a validación por expertos y análisis de confiabilidad (Alfa de Cronbach = 0,605). Resultados El nivel de conocimiento sobre la enfermedad periodontal y su relación con la diabetes mellitus, la gestación y las enfermedades cardiovasculares fue bueno en un 57,1 por ciento y regular en un 41,6 por ciento de los médicos evaluados. No se encontraron diferencias con respecto a la especialidad médica (p = 0,348) ni al tiempo de ejercicio profesional (p = 0,403). Conclusión Los resultados permiten concluir que el nivel de conocimiento sobre la enfermedad periodontal y su relación con la diabetes mellitus, la gestación y las enfermedades cardiovasculares fue bueno en el 57,1 por ciento de los médicos de los hospitales Belén y Víctor Lazarte Echegaray de Trujillo, Perú, 2014.

Objective: To determine the level of knowledge of physicians from two Peruvian hospitals on the relationship between periodontal and systemic diseases. Methods This cross-sectional and descriptive study was conducted between April and May 2014 and included a total of 77 physicians, 39 from Hospital Belen de Trujillo and 38 from Hospital Victor Lazarte Echegaray (Trujillo, Peru). They were given a questionnaire that was previously submitted for validation by experts and reliability analysis (Cronbach's alpha = 0.605). Results The level of knowledge on periodontal disease and its relationship with diabetes mellitus, cardiovascular disease and pregnancy was good in 57.1 percent and moderate in 41.6 percent of physicians who responded. No differences were found as regards medical specialty (P = .348) or professional experience (P = .403). Conclusion The results suggest that the level of knowledge on periodontal disease and its relationship with diabetes mellitus, cardiovascular disease and pregnancy was good in 57.1 percent of physicians from Victor Lazarte Echegaray and Belen hospitals in Trujillo, Peru, in 2014.

Factores de riesgo para la deshidratación hipernatrémica en neonatos atendidos en el HONADOMANI San Bartolomé durante el año 2013 / Risk factors for hypernatremic dehydration in newborn treated at the HONADOMANI San Bartolome during the year 2013

Objetivo: Determinar los factores de riesgo para la deshidratación hipernatrémica en neonatos atendidos en el HONADOMANI "San Bartolomé" durante el año 2013. Metodología: Estudio observacional, descriptivo, retrospectivo de corte transversal. Se realizó el estudio a 100 neonatos atendidos en el Hospital Nacional Docente Madre Niño "San Bartolomé" durante el año 2013. Para el análisis bivariado, se utilizó test de chi cuadrado y la razón de momios para estimar el nivel de riesgo. Resultados: Entre las características generales de los neonatos atendidos en el HONADOMANI, la edad promedio de los neonatos con hipernatremia fue de 3.9±3.2 días, y los isonatrémicos fue 2.5±2.2 días. Así como, el tiempo de vida promedio en presentarse la deshidratación hipernatrémica fue 3.9±3.2 días, y 2.6±2.1 días en los isonatrémicos. No evidenciando igualdad en los valores medios (p<0.05). Asimismo, la edad gestacional, el peso al nacer, la estancia hospitalaria, así como el peso después del diagnóstico tienen valores promedio similares en ambos grupos (p>0.05). Los neonatos hipernatrémicos perdieron en promedio 11 por ciento de su peso al nacer. Además, los valores medios del peso perdido y del sodio, no son iguales en ambos grupos (p<0.05). No obstante, si se constató igualdad en los valores promedios de la glucosa, urea, creatinina y bilirrubina (p>0.05). A su vez, la mayoría de madres con neonato hipernatrémico e isonatrémicos tenían entre 19 a 35 años, de procedencia resto de lima y de grado de instrucción secundaria completa. Entre los factores posibles de riesgo materno, la mayoría de madres de neonatos con o sin hipernatremia no tuvo experiencia previa en lactancia, esta característica tiene relación con el hallazgo de hipernatremia (p=0.024) y (OR=2.57). Pocas madres presentaron algún dolor en los pezones, la mayoría de ellas su periodo intergenésico fue largo y el tipo de parto fue vaginal. Además, no hubo factores posibles de riesgo del neonato y la mayoría de madres...

Objective: To determine the risk factors for hypernatremic dehydration in newborns attended in HONADOMANI "San Bartolomé" in 2013. Methodology: Observational, descriptive, transversal, retrospective study. The sample was 100 newborns attended in "San Bartolomé" Teaching Mother Child National Hospital in 2013. For bivariate analysis, chi square test was used; and to estimate the level of risk, odds ratios was used. Results: Among the general characteristics of newborns treated at the "San Bartolome" HONADOMANI, the average age of newborns with hypernatremia was 3.9 ± 3.2 days and the isonatremics was 2.5 ± 2.2 days. As the average life that hypernatremic dehydration presented was 3.9 ± 3.2 days, and the isonatremics was 2.6 ± 2.1 days. It was not evident equality in the mean values (p<0.05). Similarly, gestational age, birth weight, hospital stay, and the weight after diagnosis had equal mean values in both groups (p>0.05). However, equality was observed in the mean values of glucose, urea, creatinine and bilirubin (p>0.05). Most mothers with isonatremics and hypernatremic newborn were between 19 to 35 years, hometown of Lima and level of education completed secondary. Among possible maternal risk factors, most mothers of newborns with or without hypernatremia did not have previous experience in breastfeeding, this feature was related with the finding of hypernatremia (p=0.024) and (OR=2.571, CI=1122-5895). Few mothers had some sore nipples; most of them their interpregnancy period was long and the mode of delivery was vaginal. In addition, there were no possible risk factors of newborns; and most mothers did not have early discharge hospital. This feature was associated with the diagnosis of hypernatremia (p=0.002) and (OR=8.432, CI=1791-39698). Among the clinical features of dehydration in newborns, they presented mostly irritability and jaundice (approximately 70 per cent in both groups), the jaundice was re1ated with the diagnosis of hypernatremia. Less...

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index.

OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index / Consumo de iodo em escolas de ensino fundamental de Querétaro, México: correlação entre a concentração urinária de iodo, o estado nutricional geral e o índice de desigualdade social

OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

OBJETIVO E MÉTODOS: Estimar a concentração de iodo urinário (CIU) mediana e correlacioná-la com os indicadores de nutrição geral e com o índice de desigualdade social (IDS) de 50 escolas estaduais de ensino fundamental de 10 municípios do estado de Querétaro, no México. RESULTADOS: Utilizou-se um total de 1.544 crianças e encontrou-se uma ingestão acima das necessidades de iodo (CIU mediana de 297 µg/L). O nível de iodo determinado foi deficiente, adequado, mais do que adequado e excessivo em 2, 4, 19 e 25 escolas, respectivamente. Setenta e sete por cento de amostras de sal de mesa mostraram uma quantidade de iodo adequada (20-40 ppm), enquanto 9,6% das amostras tinham um teor de iodo baixo (< 15 ppm). As medianas de CIU por escola foram correlacionadas positivamente com as medianas do índice de massa corporal (IMC) usando o desvio-padrão da contagem (DP) (r = 0,47; p < 0.005), o DP da altura (r = 0,41; p < 0.05) e a prevalência de sobrepeso e de obesidade (r = 0,41; p < 0,05). As medianas de CUI por escola foram correlacionadas negativamente com a prevalência de desnutrição (r = -0.39; p = 005) e com o índice de desigualdade social (r = -0.36; p < 0,05). Os melhores modelos de regressão múltipla mostraram que a DP do IMC e a altura foram relacionados significativamente com a CIU (p < 0,05). CONCLUSÃO: Existe uma convivência entre os dois extremos de ingestão de iodo (insuficiente e excessiva). Em nosso conhecimento, a correlação positiva entre a CIU, o excesso de peso e a obesidade não foi descrita anteriormente e poderia ser explicada pela disponibilidade e consumo de alimentos ou refeições ricos(as) em energia e sal iodado.

Actitud de los padres frente al comportamiento de sus hijos hiperactivos / Attitude of the parents opposite to the behavior of his hyperactive children

Objetivo: identificar la actitud de los padres frente al comportamiento de sus hijos hiperactivos escolares que acuden al Centro Educativo Básico Especial “Los Pinos” – San Juan de Lurigancho, en el año 2009. Material y métodos: estudio de diseño descriptivo de corte trasversal realizado con 41 padres a quienes se le aplicó un test de actitud frente al comportamiento de su hijo hiperactivo. Resultados: el 58,5% de los padres encuestados mostró una actitud buena, mientras que el 41,5% presentó una actitud regular. En relación al componente cognitivo de la actitud el 44,4% de los padres mostró un nivel bueno y el 55,5% un nivel regular; el 43,47 de las madres mostró un nivel regular y un 56,5 un nivel bueno En el componente afectivo de la actitud, los padres presentaron en un 50% un nivel tanto regular como bueno; en tanto las madres, el 73,91 un nivel regular y un 26,09 un nivel bueno. En el componente conductual de la actitud el 61,11% de los padres presento una actitud buena, el 22,22% regular y el 16,6% mala. En tanto, las madres en un 86,95% presentaron una actitud buena, el 8,69 regular y el 4,34 mala. Conclusiones: más de la mitad de los padres tienen una actitud los padres en su mayor¡a cuentan con conocimientos aplicados al manejo de su hijo en relación al componente afectivo, en su mayor¡a los padres tienen una respuesta afectiva regular. En tanto en el componente conductual la respuesta de los padres fue buena

Objective: To identify the attitude of the parents opposite to the behavior of his hyperactive school children who come to the Educational Basic Special center “The Pines” Lurigancho’s San Juan, in the year 2009. Material and Methods: study of descriptive design of court trasversal realized with 41 parents to whom a test of attitude was applied opposite to the behavior of his hyperactive son. Material and Methods: Study of descriptive design of court trasversal realized with 41 parents to whom a test of attitude was applied opposite to the behavior of his hyperactive son. Results: 58,5% of the polled parents showed a good attitude, whereas 41,5% presented a regular attitude. In relation to the cognitive component of the attitude 44,4% of the parents presented in 50% a both regular and good level; while the mothers, 73, 91 a regular level and 26,09% a good level. In the behavioral component of the attitude 61,11% of the parents presented a good attitude, 22,22% to regulate and 16,6% bad. While, the mothers in 86,95% presented a good attitude, 8,69 regular and 4,34 bad. Conclusions: More than the half of the parents they have a good attitude opposite to the behavior of the hyperactive child, according to the cognitive component of the attitude the parents in the main possess knowledge applied in the managing of his son. In relation to the affective component in the parents have an affective regular response. While at the behavioral component the response of the parents was good.

El bienestar de los jóvenes en las representaciones sociales de las personas mayores / The Well-being of the Youth in the Social Representation of the Elderly

Esta investigación tuvo como objetivo identificar las representaciones sociales que las personas mayores tienen sobre el bienestar de los jóvenes, para ello se contó con la participación de dos poblaciones, una compuesta por 50 personas mayores (25 hombres y 25 mujeres) con edades comprendidas entre 60 y 70 años, y otra compuesta por 50 jóvenes (25 hombres y 25 mujeres) entre los 15 y 25 años de edad. Los datos se analizaron a partir de las categorías emergentes tras la aplicación de una entrevista semiestructurada con preguntas abiertas. Los resultados obtenidos muestran que las personas mayores asocian el bienestar de los jóvenes con las siguientes categorías: un trabajo estable y bien remunerado, una relación de pareja, acceso a la salud y la educación.

This research aimed to identify the social representations the elderly have on the well-being of the younger people. In order to that, 50 elderly (25 men, 25 women) with a range of age between 60 and 70 years were interviewed and 50 young people (25 men, 25 women) in a range between 15 and 25 years as well. The data were analyzed from the emergent categories after a semiestructured interview with open questions. The results show that the elderly's representations of well-being in the youth are related to: a stable and well paid job, a relationship, access to health and access to education.

Factores familiares y sociales de alto riesgo asociados al trabajo infantil en ciudades de la Costa Caribe colombiana / High risk family and social factors associated with child labour in cities of the colombian caribbean coast

Se describen los factores familiares y sociales de alto riesgo asociados al trabajo infantil. La muestra, de carácter intencional, estuvo constituida por 835 niños, niñas y adolescentes entre 6 y 17 años (M = 10.6 años y DE = 2.2) de las ciudades de Barranquilla, Santa Marta y Cartagena, que participaron en el proyecto "Edúcame primero, Colombia" durante 2008. Los resultados presentan datos relevantes sobre el estado sociodemográfico de los niños participantes, sus características familiares y condiciones sociales, que permitirán establecer una línea base actualizada y abrir camino para la construcción de estrategias de intervención efectivas sobre un flagelo que azota a los niños, niñas y jóvenes no solo de Colombia, sino del mundo.

The investigation describes the familiar and social factors of high risk associated with child labour. The sample of intentional character, was made up of 835 children and teenagers between 6 and 17 years (average of 10.6 years and DT = 2.2) of the cities of Barranquilla, Santa Marta, and Cartagena, which participated in the project "Educate First Your Colombia "during the year 2008. The results presented relevant data on the State population partner participating children, familiar characteristics and social conditions, to help establish a baseline updated and pave way for the construction of effective intervention strategies on a scourge that flogs the children and young people not only of Colombia but worldwide.

Iodine nutrition status in pregnant women in Mexico.

BACKGROUND: Iodine nutrition during pregnancy has become an important public health concern because of the deleterious impact of iodine deficiency on brain development during fetal and early postnatal life. Iodine nutrition status can be assessed in a population by the median urinary iodine concentration (UIC). World Health Organization, the United Nations Children's Fund, and the International Council for Iodine Deficiency Disorders have established that a median of UIC between 150 and 249 µg/L in pregnant women indicates an adequate iodine intake. The aim of this study was to assess iodine nutrition status in Mexican pregnant women. METHODS: Two hundred ninety-four pregnant women receiving prenatal care in the Public Medical Units of the State Ministry of Health for each pregnancy trimester (first, n=60; second, n=103; and third, n=131) in Queretaro, Mexico, were enrolled to assess UIC by the Sandell-Kholtoff method. RESULTS: The median of UIC was 273, 285, and 231 µg/L in the first, second, and third trimesters of gestation, respectively. Globally, the median (range) of UIC was 260 (5-1320) µg/L, and the percentage of samples with UIC below 150 µg/L was 28%. There was no significant difference between the UIC of women using iodine-containing multivitamins compared with those who reported the consumption of noniodized multivitamins (p>0.05). In addition, we found no difference between the UIC of women using iodized table salt compared with those who employed noniodized table salt, with those who did not know whether their table salt was iodized (p>0.05). CONCLUSIONS: Based on the median UIC, iodine intake in Queretaro, Mexico, is slightly above requirements during the first two trimesters, and adequate in the third trimester. The wide Mexican universal iodized salt program seems to supply adequate dietary iodine to pregnant women without health insurance in this region. However, regular monitoring of iodine status is recommended during pregnancy throughout Mexico.

Structural insights into the pre-amyloid tetramer of ß-2-microglobulin from covalent labeling and mass spectrometry.

The main pathogenic process underlying dialysis-related amyloidosis is the accumulation of ß-2-microglobulin (ß2m) as amyloid fibrils in the musculoskeletal system, and some evidence suggests that Cu(II) may play a role in ß2m amyloid formation. Cu(II)-induced ß2m fibril formation is preceded by the formation of discrete, oligomeric intermediates, including dimers, tetramers, and hexamers. In this work, we use selective covalent labeling reactions combined with mass spectrometry to investigate the amino acids responsible for mediating tetramer formation in wild-type ß2m. By comparing the labeling patterns of the monomer, dimer, and tetramer, we find evidence that the tetramer interface is formed by the interaction of D strands from one dimer unit and G strands from another dimer unit. These covalent labeling data along with molecular dynamics calculations allow the construction of a tetramer model that indicates how the protein might proceed to form even higher-order oligomers.

Structure of the preamyloid dimer of beta-2-microglobulin from covalent labeling and mass spectrometry.

Beta-2-microglobulin (beta2m) self-associates into fibrillar amyloid deposits in the musculoskeletal system of patients undergoing hemodialysis treatment. Previous studies have shown that stoichiometric amounts of Cu(II) at near physiological conditions can cause beta2m to organize into native-like dimers prior to forming amyloid fibrils. Here, we report the results from selective covalent labeling reactions combined with mass spectrometry that provide insight into the amino acid residues that mediate dimer formation in the wild-type protein. Using three complementary covalent labeling reagents, we find that the dimer interface is formed by the antiparallel stacking of ABED beta-sheets from two beta2m monomers. In addition, our data clearly indicate that a dimer interface involving the interactions of D-D strands from separate protein units as seen in the recent crystal structures of two mutant beta2m oligomers is unlikely.

Copper binding to beta-2-microglobulin and its pre-amyloid oligomers.

Beta-2-microglobulin (beta2m) deposits as amyloid fibrils in the musculoskeletal system of patients undergoing long-term dialysis treatment as a result of kidney failure. Previous work has shown that Cu(II) binding causes beta2m to organize into nativelike dimers and tetramers that precede amyloid formation. Cu(II) is then released from higher-order oligomers before mature Cu(II)-free amyloid fibrils are formed. While some of the Cu(II)-induced structural changes that enable beta2m self-assembly are starting to be revealed, the details of how the Cu(II) binding site evolves from the monomer to the dimers and tetramers are not known. Here, we report results from three mass spectrometry (MS)-based methods that provide insight into the changing Cu-beta2m interactions. We find that monomeric beta2m binds Cu(II) via the N-terminal amine, the amide of Gln2, His31, and Asp59. In the dimer and tetramer, Asp59 is no longer bound to Cu(II), but the other residues still comprise a well-defined albeit weaker binding site that is better able to release Cu(II). Consistent with this is the observation that a fraction of the tetrameric species no longer binds Cu(II) at this weakened binding site, which agrees with a previous report that suggested the tetramer as the first Cu(II)-free oligomer. Our results also provide some insight into structural changes caused by Cu(II) binding that facilitate oligomer formation. Specifically, binding by Asp59 in the monomer requires significant movement of this residue, and we propose that this repositioning is important for establishing a pair of dimer-stabilizing salt bridges between this residue and Lys19. We also find evidence that Cu(II) binding in the N-terminal region of the monomer repels Arg3, which likely allows this residue to form a pair of dimer-stabilizing salt bridges with Glu16. Overall, our measurements suggest that the previously proposed conformational switch caused by Cu(II) binding includes not only a cis-trans isomerization at Pro32 but also the repositioning of residues that are critical for the formation of new electrostatic interactions.

Probing protein structure by amino acid-specific covalent labeling and mass spectrometry.

For many years, amino acid-specific covalent labeling has been a valuable tool to study protein structure and protein interactions, especially for systems that are difficult to study by other means. These covalent labeling methods typically map protein structure and interactions by measuring the differential reactivity of amino acid side chains. The reactivity of amino acids in proteins generally depends on the accessibility of the side chain to the reagent, the inherent reactivity of the label and the reactivity of the amino acid side chain. Peptide mass mapping with ESI- or MALDI-MS and peptide sequencing with tandem MS are typically employed to identify modification sites to provide site-specific structural information. In this review, we describe the reagents that are most commonly used in these residue-specific modification reactions, details about the proper use of these covalent labeling reagents, and information about the specific biochemical problems that have been addressed with covalent labeling strategies.